Causes

Cartilage is smooth tissue that covers the areas of bone that make up a joint. It provides a cushion for the bones and helps the joint work smoothly. Over time the impact, stress, and pressure on the joint can wear down the cartilage. The damage to the cartilage can get worse over time. Eventually, the cartilage may completely wear away leaving bones to rub together.

The wear and tear of the joint is a normal part of aging. However, it may be made worse by injuries to the joint, weakness of supporting muscles, or other medical conditions.

Risk Factors

OA is more common in older adults. Other factors that may increase your chance of OA include:

Having an injury or surgery to the joint surface, especially the cartilage

Having an occupation or doing physical activities that put stress on joints

Symptoms

OA is most common in larger joints that support weight such as the spine, hips, and knees. It is also common in active joints like the hand and feet. Common symptoms include:

Mild to severe pain in a joint, especially after overuse or long periods of rest

Creaking or grating sound in the joint

Swelling, stiffness, limited movement of the joint, especially in the morning

Movement may be less stiff after starting activity

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. Other types of joint diseases or general illnesses can cause similar symptoms. To rule out other conditions your doctor may order:

Treatment

OA can not be cured. Treatment is focused on relieving symptoms and slowing damage to the cartilage. When cartilage wears away, bone on bone friction causes pain and inflammation. The goal of treatment is to reduce joint pain and inflammation, and to improve joint function.

Options may include:

Weight Reduction

Losing weight
can lessen the stress on joints affected by OA. The closer you are to your ideal weight, the greater the benefit.
A dietitian can help with meal planning.

Exercise and Physical Therapy

Muscles affect the alignment of the joint, how they move, and how much stress is placed on them. The stronger the muscles the less wear and tear happens with each movement.
Strengthening the muscles that support the joint may decrease pain and improve movement. Certain exercise options may be better than others. For example, swimming and water aerobics improve muscle health with less impact on the joints. The doctor or an exercise specialist can help develop a program.

If OA is making everyday tasks difficult, therapy may help. Physical or occupational therapy can provide new steps or devices to help do everyday tasks such as:

Shoes with shock-absorbing
in
soles

Splints or braces help to properly align joints and distribute weight.

Elastic supports

Canes,
crutches,
walkers, and orthopedic shoes

Home tools such as handrails and grips throughout your home or elevated seats, including
toilet seats

Heat and Ice

Heat may help loosen stiff joints and improve movement. Heat may be applied through hot water bottles, warm soaks, paraffin, or heating pads.

Ice may help decrease swelling and pain after activity.

Alternative Treatments

Alternative therapies may give some additional relief. It is best when used in combination with treatments above. It is important to work with your doctor to find the treatment combination that is best for you. Alternative options that have shown some promise with OA include:

Support

Chronic conditions can affect lifestyle and be very frustrating. This can lead to increased stress and unhealthy habits. The medical team or a support group can help provide options to better manage stresses associated with OA. Ideally, treatment and support will help minimize the stress on your everyday life.

Surgery

Surgery may be needed for joints with severe damage. It may be done to:

Remove loose pieces of bone or cartilage from joints

Reposition bones to better balance stress on the joint

Replace severely damaged joint with an artificial joint

Prevention

To help reduce your chance of OA:

Maintain a healthy weight.

Do regular exercise, such as walking, stretching, swimming, or yoga.

Avoid repetitive motions and risky activities that may contribute to joint injury, especially after age 40.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Hochberg MC, Altman RD, et al. American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee. Arthritis Care Res (Hoboken). 2012;64(4):465-474.

Living with arthritis. Arthritis Foundation
website. Available at:
http://www.arthritistoday.org/about-arthritis/types-of-arthritis/osteoarthritis.
Accessed May 11, 2016.

Osteoarthritis. National Institute of Arthritis and Musculoskeletal and Skin Disorders website. Available at:
http://www.niams.nih.gov/Health%5FInfo/Osteoarthritis/default.asp. Updated April 2015. Accessed May 11, 2016.